MEDICARE: MR. JONATHAN SENDA LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	8337-C	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	842974605	OTHER	NV	IRS INDIVIDUAL TAXPAYER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1639434053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JONATHAN SENDA LCSW

Provider Business Mailing Address
First Line	:	1334 S MARYLAND PKWY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-3310
Country	:	US
Telephone Number	:	702-530-5344
Fax Number	:	702-852-0413

Provider Business Practice Location Address
First Line	:	1334 S MARYLAND PKWY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104
Country	:	US
Telephone Number	:	702-530-5344
Fax Number	:	702-852-0413

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2012
Last Update Date	:	02/22/2023

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